1. The Boulevard Professional Center 1600 W. Eau Gallie Blvd. Suite 201-0
Senior Retirement Services
The Boulevard Professional Center
1600 W. Eau Gallie Blvd. Suite 201-0
Melbourne FL 32935
Presenting
Medicare and You
For your Future
Presented By
Senior Advisor
A. Cherie Kolinski

2. Understand your Medicare choices
We Will Help You …
Understand your Medicare choices
Unravel the mysteries of Medicare
Understand your options and make the right choice

3. What is Medicare?
A health insurance program established in 1965
Provides health coverage to millions of people
People age 65 and over
People who are disabled
People who are in Permanent Kidney Failure
Tf the Social Security Act was in 1935 by Franklin D Roosevelt and then the Medicare health insurance program was established in 1965 by Lynden B Johnson and in 1972 it was expanded to cover Disability.
Now Providing health coverage to over 44 million people
People age 65 +
People who are disabled
People who are in permanent kidney failure

4. About Medicare Insurance Company's Med-Supp policies
Can apply 3 months prior to turning 65
Medicare Insurance Insurance Company applications to be taken up to six months in advance of Medicare effective date if,
First-time Med-Supp applicants age 64½ and above
Not currently on a Med-Supp disability policy
CMS regulation allows applicants to apply 3 months prior to turning 65
United American allows advance dating
Up to six months in advance of Medicare effective date.
For first-time Med-Supp applicants age 64½ and above or
Not currently on a Med-Supp disability policy

5. Medicare Basics – Medicare Advantage (Part C)
Optional Part D
Part A
Part B
Usually Part D
Can not join a Medicare Advantage Plan (Part C) and purchase a Medicare Supplement Insurance (Medigap) policy

6. Medicare Basics – Original Medicare
Optional Part D
Part A
Part B
Optional Medicare Supplement Insurance (Medigap)

7. Medicare Part A – Hospital
Automatic Enrollment (if receiving Social Security benefits)
Eligible at age 65, or 2 years on disability
Premium-free for most people, if
Eligible for Social Security or Railroad benefits
You or your spouse had Medicare-covered government employment
Source: medicare.gov

8. Medicare Part A – Hospital
Medicare Part A – Coverage
Inpatient Hospital Room and Board
Skilled Nursing Facility (not Long Term Care)
Hospice and Respite Care services
Some Home Health Care services
Blood
Source: medicare.gov

9. Medicare Part A – Hospital (Out-of-Pocket Costs)
Day 1-60 $1156 Deductible
Day $289 per day
Day $578 per day
SKILLED NURSING CARE:
Minimum 3 day hospital stay
Day 1-20 Covered
Day $ per day
BLOOD
First 3 pints usually covered
HOSPICE CARE
Terminally ill with less than 6 months to live
Hospital
Day 1-60
$1,288 Deductible
Day 61-90
$322 per day
Day
$644 per day
Skilled Nursing Care
Minimum 3 day hospital stay
Day 1-20
Covered
Day
$161 per day
Hospice Care
Terminally ill (with less than 6 months to live)
Blood
First 3 pints usually covered
Source: medicare.gov

10. Medicare Part B – Medical
Optional Enrollment
Can delay Part B enrollment if on Employer Group Medical Plan
Monthly Premium (deducted from Social Security check)
$ (income dependent)
Enroll 3 months prior to age 65 (including month of birthday)
Enroll no later than 3 months after birthday – 7 months total
Source: medicare.gov

11. Medicare Part B – Medical
Medicare Part B – Coverage
Doctor Services
Outpatient Care
‘Welcome to Medicare’ visit
Preventive Services (flu shots)
Ambulance Services
Doctor services
Outpatient care
‘Welcome to Medicare’ visit
Preventative services (flu shots)
Ambulance services
Source: medicare.gov

12. Medicare Part B – Medical
Medicare Part B – Coverage (continued)
Cancer Screenings and Chemo
Diabetes Screenings and Supplies
Durable Medical Equipment
Limited Chiropractic, Vision, Hearing
OT/PT and Laboratory Services
Cancer screenings & chemo
Diabetes screenings & supplies
Durable medical equipment
Limited chiropractic, vision, hearing
OT/PT and Laboratory Services

13. Medicare Part B – Medical [ Out-of-Pocket Costs ]
HOSPITAL:
Day 1-60 $1156 Deductible
Day $289 per day
Day $578 per day
SKILLED NURSING CARE:
Minimum 3 day hospital stay
Day 1-20 Covered
Day $ per day
BLOOD
First 3 pints usually covered
HOSPICE CARE
Terminally ill with less than 6 months to live
Premium
$ per month deducted from Social Security check
Deductible
$166 per year
Coinsurance
20% of Medicare approved charges
PREMIUM:
$ per month
Deducted from Social Security check
ANNUAL DEDUCTIBLE:
$166
COINSURANCE
20%
Source: medicare.gov

14. A/B Chart

15. Medicare Part D – Prescription Drug
Enroll After Parts A and B
Guaranteed Acceptance
Can get with a Medicare Advantage Plan
Can get as a Stand Alone Prescription Drug Plan (PDP)
May pay penalty if not enrolled when first eligible
Enroll after Parts A/B
Guaranteed acceptance
Can get with a Medicare Advantage Plan
Can purchase stand alone Prescription Drug Plan (PDP)
May pay penalty if not enrolled when first eligible
* NEED SOURCE

16. Medicare Part D – Prescription Drug (d)
Can get Low Income Subsidy (LIS)/Extra Help Assistance:
Single Income < $17,655; Resources < $13,640*
Couples Income < $23,895; Resources < $27,250*
Must Select a Private Drug Plan
Choose by Plan Formulary
*Income limits are currently based on 2015 income limitHealth & Human Services Centers for Medicare s at 150% of poverty and will be updated in early 2016.
Source: Department of & Medicaid Services
Can get Low Income Subsidy (LIS)/Extra Help assistance:
Single Income < $17,655/Yr; Resources < $13,640*
Couples Income < $23,895/Yr ; Resources < $27,250*
Must select a private drug plan
Choose by plan formulary
Etc.

17. Medicare Part D – Prescription Drug (Out-of-Pocket Costs)
HOSPITAL:
Day 1-60 $1156 Deductible
Day $289 per day
Day $578 per day
SKILLED NURSING CARE:
Minimum 3 day hospital stay
Day 1-20 Covered
Day $ per day
BLOOD
First 3 pints usually covered
HOSPICE CARE
Terminally ill with less than 6 months to live
Premium
Varies based on which plan and company you choose
Deductible
$360 per year (some plans have $0 deductible)
Coverage Gap (Donut Hole)
Annual out-of-pocket exceeds $3,310 up to $4,850
Includes co pays, coinsurance, and deductibles
Catastrophic Coverage
Annual out-of-pocket meets or exceeds $4,850
Small co pay for all prescription drugs
PREMIUM:
Depends which plan and company you choose
ANNUAL DEDUCTIBLE:
$360 (some plans have $0)
COVERAGE GAP (Donut hole):
Annual Out-of-Pocket exceeds $3,310 up to $4,850
Includes copays, coinsurance, and deductibles
CATASTROPHIC COVERAGE:
Annual Out-of-Pocket meets or exceeds $4,850
Small copay for all RX
Source: medicare.gov

18. Medicare Part C – Medicare Advantage
About Medicare Part C
Can join or switch plans only during certain times of the year
Must cover at least what Medicare covers
Some plans charge small monthly premiums, others do not
The Maximum out-of-pocket (MOOP) costs vary by plan and can go up to $10,000
Can join or switch plans only during certain times of the year
Must cover at least what Medicare covers
Some plans charge small monthly premiums, others do not
The Maximum Out-of-Pocket (MOOP) costs vary by plan and can go up to $10,000

19. Medicare Part C – Medicare Advantage
About Medicare Part C
Benefits and Premiums can change annually
You cannot own a Medicare Supplement and a Medicare Advantage plan
NOT Guaranteed Renewable
You cannot own a Medicare Supplement with a Medicare Advantage (PD) plan
Benefits and Premiums can change annually
Over last few years, MOOP expenses have climbed exponentially
Advantage plans are NOT guaranteed renewable (plan member)

20. Medicare Part C – Medicare Advantage
About Medicare Part C
Some plans have certain rules to follow, like referrals, etc.
You may have to use providers who belong to the plan
Insurers can opt out of these plans
Doctors can opt out of these plans
Hospitals can opt out of these plans
Some plans have certain rules to follow, like referrals, etc.
You may have to use certain providers who belong to the plan
Insurers can opt out of these plans
Doctors can opt out of these plans
Hospitals can opt out of these plans

21. Medicare Supplement Plans (Medigap)
Plans available to help cover the Gap
Medicare Approved Charges
Excess Charges
GAP
Senior Pays Excess Charges
Senior Pays 20%
Medicare Pays 80%
Senior Pays Deductibles,
Coinsurance,
and Copays
Helps covers the “gaps” in Medicare:
Deductibles
Coinsurance
Copays
Excess Charges
These amounts change each year but Medigap plans cover it

22. Medicare Supplement Plans (Medigap)
11 Standardized plans available A B C D F
HDF G K L M N
Plan F is the most comprehensive
11 Standardized plans available: Plan F is most comprehensive

23. Medicare Supplement Plans (Medigap)
All Med-Supp Plans are Guaranteed Renewable
Flexibility and Freedom to Choose
Any Doctor *
NO referrals
Any Hospital *
NO networks
Any Specialist *
All Medicare Supplement plans are GUARANTEED RENEWABLE
Flexibility and Freedom to choose any Doctor, Hospital, or Specialist that takes Medicare with NO referrals and NO networks
* That accepts Medicare

24. Medicare Supplement Plans (Medigap)
All Companies Must Follow Federal and State Laws
Costs Vary By
Companies Vary By
Company
Ratings
Where you Live
Stability
Plan Selected
All companies must follow Federal and State laws
Costs vary by company, where you live, and by the plan
Financial ratings and stability vary by com

25. Medicare Supplement Plans
How are Medicare Supplement plans priced?
Issue Age
Rated 65 $
66-69
70-75
76-79
80+
Premium based on age when policy purchased
Issue Age Rated
Premium based on age when policy purchased

26. Medicare Supplement Plans
United American’s Medicare Supplement Plans in Florida
Issue Age Rated
Premium based on age when policy purchased
Sex Distinct
Premium rated on policyholder’s gender
Preferred Rates
No tobacco use

27. Medicare Supplement Plans
Rate Adjustments
Helps keep pace with
Rising Medicare claim trends
Changes in annual deductibles

28. Medicare Supplement Open Enrollment Qualifiers
Enrolled in Medicare Parts A and B
Within 6 months before and after you turn age 65
Cannot be denied during the Open Enrollment period
Cannot be charged more because of health
Medicare Supplement Guaranteed Issue Qualifiers
Must be on Original Medicare and Involuntarily Disenrolled from your Employer’s Group Health Plan
Involuntarily Disenrolled from your Medicare Advantage Plan
Must go through underwriting if outside Open Enrollment
Must be enrolled in Medicare PARTS A & B
6 months before and 6 months after you turn 65
Cannot be denied during this Guaranteed Issue period
Cannot be charged more because of health
If replacing an existing Medigap plan (creditable coverage)
No waiting period
No pre-existing limitations
NOTE: Must go through underwriting if outside Open Enrollment or Guaranteed Issue Periods
Involuntarily disenrolled from your employer’s plan
Involuntarily disenrolled from your employer’s Medicare Advantage (PD) plan
No pre-exisitng
NOTE: Must go through underwriting if outside Open Enrollment or Guaranteed Issue Period
Source: medicare.gov

29. Medicare Advantage 2014 Pre-Enrollment Period
October 1 – October 14
Annual Election Period (AEP)
October 15 – December 7
Annual Disenrollment Period
January 1 – February 14
Pre-Enrollment Period
Annual Election Period (AEP)
Annual Disenrollment Period
Oct 1 – Oct 14
Oct 15 – Dec 7
Jan 1 – Feb 14
Pre-Enrollment Period
October 1 – October 14
Annual Election Period (AEP)
October 15 – December 7
Annual Disenrollment Period
January 1 – February 14
Source: medicare.gov

30. Premium Savings
Q: How do people save money on any kind of insurance (health, car, homeowners)?
A: They raise their deductible …
And Save
Premiums $$$

31. Popular Medicare Supplement Plans
Basic Benefits
Skilled Nursing Facility Coinsurance
Part A Deductible – $1,288
Part B Deductible – $166
Excess Doctor Charges
Foreign Travel Emergency
Calendar-Year Deductible, or Out-of-Pocket Annual Limit
Hospitalization (Part A Coinsurance)
Medical Expenses (Part B Coinsurance)
Blood
Hospice
Plan F 
100%
80%
Plan HDF 
100%
80%
Foreign Travel
$250 deductible
$50,000 max
$2,180

32. Michelle has an HDF policy
What happens when she has a Part B claim?
HDF Claim Example
Total approved Part B Doctor Claim
$100
Medicare’s 80% of Approved Charge
$80
Customer’s 20% of Approved Charge
$20
If deductible is reached Senior owes
$0 *
* Policyholder must meet HDF calendar-year deductible ($2,180 in 2016) before benefits begin, and pay his/her HDF premiums.
HDF Premium: Florida Area 1 (Preferred) – Female = $49 | Male = $57
For Illustrative Purposes Only

33. Monthly Premium Savings
How HDF may be suitable coverage for Senior health needs AND budget
Husband
Wife
Plan F monthly premium
$248
$216
Plan HDF monthly premium *
$63
$55
Monthly Premium Savings
$185
$161
Current rates as of January 2014
* UA ProCare, Age 65 Nonsmoker, Florida Area 2
For Illustrative Purposes Only

34. Annual Premium Savings **
How HDF may be suitable coverage for Senior health needs AND budget
Husband
Wife
Monthly Premium Savings
$185
$161
12 Months 12
Annual Premium Savings **
$2,220
$1,932
$4,152 Combined Annual Savings
* UA ProCare, Age 65 Nonsmoker, Florida Area 2
** Example assumes no rate increases on either plan; policyholder must meet HDF calendar-year deductible ($2,180 in 2016) before benefits begin
For Illustrative Purposes Only

35. Premium Savings Example
Husband
Wife
Annual Premium Savings **
$2,220
$1,932
10 Years 10
10 Year Premium Savings
$22,200
$19,320
$41,520 Combined Premium Savings
* UA ProCare, Age 65, Nonsmoker, Florida Area 2
** Example assumes no rate increases on either plan; policyholder must meet HDF calendar-year deductible ($2,180 in 2016) before benefits begin
For Illustrative Purposes Only

36. 3% Reserve Fund Annuity $50 per month minimum deposit
Helps pay Med-Supp deductible or copayment
Interest rate guaranteed
No lock-in time for deposits
$50 per month minimum deposit
$5,000 per year maximum deposit
No start-up costs
No surrender fees or commission loads
Can be purchased along with Medicare Supplement plans A, B, D, HDF, G, K and L 3%
RESERVE FUND ANNUITY
UA offers a unique product – RFA assists Med-Supp policyholders with paying HDF calendar-year deductible or copayment
RFA’s interest rate is guaranteed at 3%
No lock-in time for deposits, no surrender charges, and no commission loads
Open with as little as $50 (up to a maximum of two times the annual deductible or $4,360 initial deposit in 2015) and can deposit up to $5,000 per year.
Can be purchased along with Medicare Supplement plans A, B, D, HDF, G, K and L

37. Today’s Medicare Environment Includes more Coverage Options for You!
Includes all the benefits of:
Original Medicare
(Part A-Hospital)
(Part B-Medicare) Or
Medicare Advantage health plan only (MA only)
MA only with stand-alone Part D
MAPD-MA health plan with Part D included

38. How do I Choose…
Which plan is right for me?
Do you want to choose your own specialists without referrals and not worry about networks?
YES

39. How do I Select a Carrier ?
Why choosing a carrier is important
How quickly do they issue policies and pay claims?
Split into multiple slides -mt

40. Split into multiple slides -mt
Why choosing a carrier is important
Do they outsource their Customer Service call center or is it here in the USA?
Split into multiple slides -mt

41. Thank You Cherie Kolinski
SENIOR RETIREMENT SERVICES
THE BOULAVARD PROFESSIONAL CENTER
1600 W. Eau Gallie Blvd #201-0
Melbourne FL 32935